Electrosurgical tissue and vessel sealing device

ABSTRACT

An electrosurgical device can be delivered to a tissue site to provide supplemental sealing of vessels and/or vascular tissue that include suturing, stapling, or the like. The electrosurgical device is generally in the form of forceps, and includes an end effector assembly including opposing movable jaws. Each jaw includes a deformable pad or cushion including an electrode array positioned thereon. Each deformable cushion is configured to deliver a fluid, such as saline, during activation of the electrode array, thereby creating a virtual electrode which couples radiofrequency (RF) energy emitted from the electrode array into tissue in which the RF energy is converted into thermal energy. The deformable cushion and electrode array provide a controlled degree of compression upon the target tissue or vessel to maintain integrity of a suture, staple, or clip, as well as controlled energy emission for sealing, cauterizing, coagulating, and/or desiccating the target tissue or vessel.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application claims the benefit of, and priority to, U.S.Provisional Application No. 62/419,227, filed Nov. 8, 2016, the contentof which is hereby incorporated by reference herein in its entirety.

FIELD

The present disclosure relates generally to medical devices for sealingtissue, and, more particularly, to an electrosurgical device in the formof forceps including an end effector assembly including opposing jawsfor providing controlled compression and energy emission for sealing,cauterizing, coagulating, and/or desiccating vessels and vascular tissueincluding been previously sutured or stapled.

BACKGROUND

Most surgical procedures require some form of closure of a vessel,wound, or incision. For example, in many procedures, a surgeon will relyon sutures as a means of surgically occluding a vessel, closing wounds,as well as coupling portions of tissue to one another (e.g., bypasssurgeries and anastomoses formation). More recently, surgical staplesand clips have become commonly used in place of sutures, whereappropriate, as stapling can be much faster than suturing by hand, andcan also be more accurate and consistent. Furthermore, stapling may notrequire the degree of experience and expertise that suturing generallyrequires. Staples may primarily be used in bowel and lung surgery,because staple lines may be more consistent and therefore less likely toleak blood, air or bowel contents.

While the use of staples for thoracic surgery has been widely acceptedand regarded as a safe procedure, there are instances in which staplingis may be insufficient and unable to achieve complete closure of awound, incision, or vessel. This may be particularly critical in certainthoracic procedures, particularly those involving pulmonary vasculaturewhere the leakage of air and/or fluid contents can be life threatening.

In some procedures, a surgeon may rely on an electrosurgical device toseal or cauterize a vessel, wound, or incision by applying energy (e.g.,electrical current, radiofrequency (RF), thermal energy, etc.) to thetarget tissue or vessel. Some current devices, particularlyelectrosurgical forceps, use mechanical action between opposing jaws toconstrict tissue and further apply electrical energy to effecthemostasis by heating the tissue and blood vessels to coagulate,cauterize, cut and/or seal tissue. While current electrosurgical forcepsallow for the sealing of tissue or vessels, such devices haveshortcomings and are unable to be used in conjunction with suturesand/or staples. For example, some sutures and staples may be fragile(e.g., formed from bioabsorbable materials) and thus may be unable towithstand the compression forces and/or energy delivered via currentelectrosurgical forceps. Thus, the use of current electrosurgicalforceps on a vessel or wound that includes a suture or staple may resultin damage to the suture or staple, which may compromise the integrity ofthe seal and may further result in serious complications, such as anincrease in wound severity as well as life-threating infection.

SUMMARY

An electrosurgical device can be delivered to a surgical site to providesealing of vessels and/or vascular tissue. The device is useful forsupplementing an initial closure of a vessel, wound, or incision viasuturing or stapling. In particular, the device is configured to applycontrolled compression and energy emission to the vessel, wound, orincision while maintaining the integrity of the suture or staple (i.e.,without damaging the suture or staple). Accordingly, the electrosurgicaldevice of the present disclosure provides for complete closure, therebypreventing leakage of air, contents, or fluid and subsequentlypreventing infection or life threatening complications.

The electrosurgical device is generally in the form of forceps andincludes a probe acting as a handle and an end effector assemblypositioned at a distal end of the probe. The end effector assemblyincludes opposing jaws configured to move relative to one anotherbetween open and closed positions upon corresponding input from thesurgeon (i.e., via control from a trigger on the probe). Each jawincludes a deformable pad or cushion including an electrode arraypositioned along an exterior surface thereof and is configured toprovide controlled compression upon a target tissue or vessel andsubsequent delivery of radiofrequency (RF) energy for effectivelysealing, cauterizing, coagulating, and/or desiccating the target tissueor vessel while maintaining the integrity of any suture(s) or staple(s).

In particular, the deformable cushion may generally include anonconductive material that is flexible and configured to transitionfrom a default shape (e.g., generally planar contact surface) to adeformed shape (e.g., one or more portions of contact surface becomecompressed) upon contact with a vessel or tissue and correspondingsuture(s) or staple(s). The compression of the cushion allows for theelectrode array to better conform to the contour of the target tissue orvessel on either side of a suture or staple, thereby improving contactand ablation/coagulation performance and enabling effective sealingaround the suture or staple.

The electrode array on each cushion is configured to emit a non-ionizingradiation, such as RF energy, in a bipolar configuration for sealing,cauterizing, coagulating, and/or desiccating the vessel or tissue. Theelectrode array is composed of one or more conductive members (e.g.,conductive wires) positioned along a length of the exterior surface ofthe cushion. In some embodiments, each of the plurality of conductivewires, or one or more sets of a combination of conductive wires, may beconfigured to independently receive an electrical current from an energysource (e.g., RF generator) and independently conduct energy, the energyincluding RF energy. This allows energy to be selectively delivered to adesignated conductive wire or combination of conductive wires. Thisdesign also enables the ablation device to function in a bipolar modebecause a first conductive wire (or combination of conductive wires) candeliver energy to the surrounding tissue through its electricalconnection with an ablation generator while a second conductive wire (orcombination of conductive wiress) can function as a ground or neutralconductive member.

The electrosurgical device is configured to deliver the RF energy via avirtual electrode arrangement, which includes distribution of a fluidalong the exterior surface of each cushion and, upon activation of theelectrode array, the fluid may carry, or otherwise promote, energyemitted from the electrode array to the surrounding tissue. Inparticular, each cushion includes one or more perforations in fluidcommunication with at least one lumen of the probe shaft configuredreceive a fluid, such as saline, from a fluid source. The one or moreperforations allow the passage of the fluid to the exterior surface ofthe cushion. Upon transitioning the opposing jaws to the closedposition, the corresponding cushions engage opposing sides of the targettissue or vessel, including one or more sutures or staples. The surgeoncan apply force so as to compress the target tissue or vessel betweenthe opposing cushions, wherein the exterior surface of each cushiongenerally conforms to the surface of the tissue or vessel and thesuture(s) or staple(s) while maintaining the integrity of the suture orstaple (i.e., without damaging the suture or staple). Due to theconforming nature of the cushions, each electrode array is able to comeinto contact with, and effectively seal, portions of the target tissueor vessel that are immediately adjacent to the suture(s) or staple(s),which are generally missed with current electrosurgical forceps.

The surgeon may then activate both the fluid delivery and eletrodearray, each of which can be independently controlled via a controller.The fluid weeping through the perforations to the outer surface of thecushions is able to carry energy from electrode array, thereby creatinga virtual electrode. Upon the fluid weeping through the perforations, apool or thin film of fluid is formed on the exterior surface of thecushions and is configured to seal portions of the target tissue ofvessel in contact therewith via the RF energy carried from the electrodearray. Accordingly, the electrosurgical device of the present disclosureprovides for complete closure of the target tissue or vessel, therebypreventing or reducing the risk of leakage of air, contents, or fluidand subsequently preventing infection or life threatening complicationsthat may otherwise occur with simply a suture or staple closure.

The electrosurgical device of the present disclosure provides numerousadvantages. In particular, the electrosurgical device is useful forsupplementing an initial closure of a vessel, wound, or incision viasuturing or stapling. The deformable cushion on each opposing jaw isconfigured to deform upon being compressed against the target tissue orvessel and the suture(s) or staple(s) such that the exterior surface ofeach cushion conforms and corresponds to the tissue or vessel surfaceand suture(s) or staple(s). The cushion is able to be compressed againstthe suture or staple without causing phyiscal damage thereto orcomprimising the structural integrity of the suture or staple.Furthermore, due to the conforming nature of the cushions, eachelectrode array is able to come into contact with, and effectively seal,portions of the target tissue or vessel that are immediately adjacent tothe suture(s) or staple(s), which are generally missed with currentelectrosurgical forceps as a result of the rigid, non-compliant sealingplates of such forceps. The virtual electrode arrangement of the presentdevice further allows for a non-sticking surface during a sealingprocedure, as the saline generally acts as a buffer between the tissuesurface and the surface of the conductive wires. Furthermore, thevirtual electrode provides for controlled emission of energy, includingat least length of elapsed time and intensity, which, in turn,effectively controls the thermal energy released for sealing, which canbe consistently maintained between 60° C. and 100° C. to preventinadvertent damage to surrounding tissue.

BRIEF DESCRIPTION OF THE DRAWINGS

Features and advantages of the claimed subject matter will be apparentfrom the following detailed description of embodiments consistenttherewith, which description should be considered with reference to theaccompanying drawings, wherein:

FIGS. 1A and 1B are schematic illustrations of an electrosurgical systemconsistent with the present disclosure;

FIG. 2 is a perspective view of one embodiment of an electrosurgicaldevice compatible with the system of FIG. 1A;

FIG. 3 is an enlarged view of the end effector assembly of the device ofFIG. 2 in greater detail;

FIG. 4 is a plan view of an exterior contact surface of a deformablecushion and an electrode array positioned thereon;

FIGS. 5A and 5B are front views of the opposing jaws of the end effectorassembly of the device of FIG. 2 in open and closed positions,respectively;

FIG. 6 is an enlarged view of another embodiment of an end effectorassembly compatible with an electrosurgical device consistent with thepresent disclosure;

FIG. 7 is a plan view of one of the opposing jaws of the end effectorassembly of FIG. 6 illustrating the deformable cushion and electrodearray provided thereon;

FIG. 8 illustrates positioning of the end effector assembly of FIG. 2for sealing of a stapled portion of lung tissue (lobe) in an opensurgical environment;

FIG. 9 illustrates positioning of the end effector assembly of FIG. 6for sealing of a stapled bronchial passageway via laparoscopicprocedure; and

FIGS. 10A and 10B are side views of the end effector assembly of FIG. 2in open and closed positions, respectively, relative to a portion ofstapled lung tissue (FIG. 8), illustrating the cushions of the opposingjaws transitioning from a default shape (FIG. 10A) to a deformed shaped(FIG. 10B) and conforming to the tissue surface and in compliance withthe staples.

For a thorough understanding of the present disclosure, reference shouldbe made to the following detailed description, including the appendedclaims, in connection with the above-described drawings. Although thepresent disclosure is described in connection with exemplaryembodiments, the disclosure is not intended to be limited to thespecific forms set forth herein. It is understood that various omissionsand substitutions of equivalents are contemplated as circumstances maysuggest or render expedient.

DETAILED DESCRIPTION

By way of overview, the present disclosure is generally directed to anelectrosurgical device can be delivered to a surgical site to providesealing of vessels and/or vascular tissue. The device is useful forsupplementing an initial closure of a vessel, wound, or incision viasuturing or stapling. In particular, the device is configured to applycontrolled compression and energy emission to the vessel, wound, orincision while maintaining the integrity of the suture or staple (i.e.,without damaging the suture or staple). Accordingly, the electrosurgicaldevice of the present disclosure provides for complete closure, therebypreventing leakage of air, contents, or fluid and subsequentlypreventing infection or life threatening complications.

The electrosurgical device is generally in the form of forceps andincludes a probe acting as a handle and an end effector assemblypositioned at a distal end of the probe. The end effector assemblyincludes opposing jaws configured to move relative to one anotherbetween open and closed positions upon corresponding input from thesurgeon (i.e., via control from a trigger on the probe). Each jawincludes a deformable pad or cushion including an electrode arraypositioned along an exterior surface thereof and is configured toprovide controlled compression upon a target tissue or vessel andsubsequent delivery of radiofrequency (RF) energy for effectivelysealing, cauterizing, coagulating, and/or desiccating the target tissueor vessel while maintaining the integrity of any suture(s) or staple(s).The electrosurgical device is configured to deliver radiofrequency (RF)energy via a virtual electrode arrangement, which includes distributionof a fluid along the exterior surface of each cushion and, uponactivation of the electrode array, the fluid may carry, or otherwisepromote, energy emitted from the electrode array to the surroundingtissue. In particular, each cushion includes one or more perforations influid communication with at least one lumen of the probe shaftconfigured receive a fluid, such as saline, from a fluid source. The oneor more perforations allow the passage of the fluid to the exteriorsurface of the cushion. Upon transitioning the opposing jaws to theclosed position, the corresponding cushions engage opposing sides of thetarget tissue or vessel, including one or more sutures or staples. Thesurgeon can apply force so as to compress the target tissue or vesselbetween the opposing cushions, wherein the exterior surface of eachcushion generally conforms to the surface of the tissue or vessel andthe suture(s) or staple(s) while maintaining the integrity of the sutureor staple (i.e., without damaging the suture or staple). Due to theconforming nature of the cushions, each electrode array is able to comeinto contact with, and effectively seal, portions of the target tissueor vessel that are immediately adjacent to the suture(s) or staple(s),which are generally missed with current electrosurgical forceps.

The surgeon may then activate both the fluid delivery and eletrodearray, each of which can be independently controlled via a controller.The fluid weeping through the perforations to the outer surface of thecushions is able to carry energy from electrode array, thereby creatinga virtual electrode. Upon the fluid weeping through the perforations, apool or thin film of fluid is formed on the exterior surface of thecushions and is configured to seal portions of the target tissue orvessel in contact therewith via the RF energy carried from the electrodearray. Accordingly, the electrosurgical device of the present disclosureprovides for complete closure of the target tissue or vessel, therebypreventing or reducing the risk of leakage of air, contents, or fluidand subsequently preventing infection or life threatening complicationsthat may otherwise occur with simply a suture or staple closure.

FIGS. 1A and 1B are schematic illustrations of an electrosurgical system10 for providing sealing of vessels and/or tissue of a patient 12. Theelectrosurgical system 10 generally includes an electrosurgical device14, which includes a probe including an end effector assembly 16 and anelongated catheter shaft 17 to which the end effector assembly 16 iscoupled. The catheter shaft 17 may generally include a nonconductiveelongated member including at least a fluid delivery lumen, as will bedescribed in greater detail herein. The electrosurgical device 14 mayfurther be coupled to a device controller 18, a radiofrequency (RF)generator 20 over an electrical connection (electrical line 30 shown inFIG. 2), and an irrigation pump or drip 22 over a fluid connection(fluid line 34 shown in FIG. 2).

The device controller 18 may include hardware/software configured toprovide a user with the ability to control electrical output to theelectrosurgical device 14 in a manner so as to control energy output toa tissue or vessel intended to be sealed or that has initially undergonesuturing or stapling. For example, as will be described in greaterdetail herein, the electrosurgical device may be configured to operateat least in a “bipolar mode” based on input from a user (e.g., surgeon,clinician, etc.) resulting in the emission of radiofrequency (RF) energyin a bipolar configuration. In some embodiments, the device 14 may beconfigured to operate in other modes, such as a “measurement mode”, inwhich data can be collected, such as certain measurements (e.g.,temperature, conductivity (impedance), etc.) that can be taken andfurther used by the controller 18 so as to provide an estimation of thestate of tissue during a sealing procedure, as will be described ingreater detail herein. In some embodiments, the device controller 18 maybe housed within the electrosurgical device 14. The RF generator 20 mayalso be connected to a separate return electrode 15 that is attached tothe skin of the patient 12.

As will be described in greater detail herein, during a sealingprocedure, the generator 20 may generally provide RF energy (e.g.,electrical energy in the radiofrequency (RF) range (e.g., 350-800 kHz))to an electrode array of the electro surgical device 14, as controlledby the device controller 18. At the same time, saline may also beprovided to and released from the end effector assembly 16. In someembodiments, the RF energy travels through the blood and tissue of thepatient 12 to a return electrode and, in the process, provides energyemission (e.g., sealing, cauterizing, coagulating and/or desiccating) totissue adjacent to portions of the electrode array that have beenactivated.

FIG. 2 is a perspective view of electrosurgical device 14. As previouslydescribed, the electrosurgical device 14 includes a probe 17 includingan elongated shaft configured as a handle and adapted for manualmanipulation. Accordingly, as shown in FIG. 2, the probe 17 is in theform of a handle including a distal end 26 to which the end effectorassembly 16 is coupled and a proximal end 28. The probe 17 may generallyresemble forceps, for example, and thus may further include a trigger 40allowing for a surgeon to control operation of the end effector assembly16 (i.e., control opening and closing of opposing jaws 38 a, 38 b), aswill be described in greater detail herein. As shown, the proximal end28 of the probe 17 may be coupled to the generator 20 and the irrigationpump 22 via connection lines or fittings. For example, the probe 17 iscoupled to the generator 20 via an electrical line 30 and coupled to theirrigation pump 22 via a fluid line 34. Each of the electrical line 30and fluid line 34 may include an adaptor end 32 and 36 configured tocouple the associated lines with a respective interface on the generator20 and irrigation pump 22.

In some examples, the electrosurgical device 14 may further include auser interface (not shown) serving as the device controller 18 and inelectrical communication with at least one of the generator 20, theirrigation pump 22, and the electrosurgical device 14. The userinterface may include, for example, selectable buttons for providing anoperator with one or more operating modes with respect to controllingthe energy emission output of the device 14, as will be described ingreater detail herein. For example, selectable buttons may allow a userto control electrical output to the electrosurgical device 14 in amanner so as to control the sealing, cauterizing, coagulating, and/ordesiccating of portions of a tissue or vessel. Furthermore, in someembodiments, selectable buttons may provide an operator to control thedelivery of fluid from the irrigation pump 22.vvAs shown, the endeffector assembly 16 includes first and second jaws 38 a, 38 b generallyopposing one another and configured to move relative to one another inresponse to user interaction with the trigger 40, as will be describedin greater detail herein.

FIG. 3 is an enlarged view of the end effector assembly 16 in greaterdetail. As shown, each jaw 38 a, 38 b includes a deformable pad orcushion (hereinafter referred to as “cushion 42”) including an electrodearray 44 positioned along an exterior surface thereof. Each cushion 42is configured to provide controlled compression upon a target tissue orvessel and subsequent delivery of radiofrequency (RF) energy foreffectively sealing, cauterizing, coagulating, and/or desiccating thetarget tissue or vessel while maintaining the integrity of any suturesor staples on the target tissue or vessel.

In particular, the deformable cushion may generally include anonconductive material that is flexible and configured to transitionfrom a default shape (e.g., generally planar contact surface) to adeformed shape (e.g., one or more portions of contact surface becomecompressed) upon contact with a vessel or tissue and correspondingsutures or staples (see FIGS. 9A and 9B). Accordingly, the nonconductivedeformable cushion 42 may include an elastomeric or shape memorymaterial. The compression of the cushion 42 allows for the electrodearray 44 to better conform to the contour of the target tissue or vesselon either side of a suture or staple, thereby improving contact andablation/coagulation performance and enabling effective sealing aroundthe suture or staple.

FIG. 4 is a plan view of an exterior contact surface of a deformablecushion 42 and an electrode array 44 positioned thereon. The cushion 42may have a length L in the range of 2-10 cm, and, in some embodiments,the length L may be 3-5 cm. The cushion 42 may have a width in the rangeof 0.5 mm to 3 mm, and, in some instances, is in the range of 0.7 to 1mm. The electrode array 44 on each cushion 42 is configured to emit anon-ionizing radiation, such as RF energy, in a bipolar configurationfor sealing, cauterizing, coagulating, and/or desiccating the vessel ortissue. The electrode array 44 is composed of one or more conductivemembers 46 (e.g., hereinafter referredto as “conductive wire(s) 46”)positioned along a length of the exterior surface of the cushionn 42. Insome embodiments, each of the plurality of conductive wires 46, or oneor more sets of a combination of conductive wires 46, may be configuredto independently receive an electrical current from an energy source(e.g., the RF generator 20) and independently conduct energy, the energyincluding RF energy. This allows energy to be selectively delivered to adesignated conductive wire 46 or combination of conductive wires 46.This design also enables the electrosurgical device 14 to function in abipolar mode because a first conductive wire (or combination ofconductive wires) can deliver energy to the surrounding tissue throughits electrical connection with an RF generator while a second conductivewire (or combination of conductive wiress) can function as a ground orneutral conductive member. The conductive wires 46 can be formed of anysuitable conductive material (e.g., a metal such as stainless steel,nitinol, or aluminum).

Since each conductive wire 46 in the electrode array 44 may beelectrically independent, each conductive wire 46 can be connected in afashion that allows for impedance measurements using bipolar impedancemeasurement circuits. For example, the conductive wires can beconfigured in such a fashion that tetrapolar or guarded tetrapolarelectrode configurations can be used. For instance, one pair ofconductive wires could function as the current driver and the currentreturn, while another pair of conductive wires could function as avoltage measurement pair. Accordingly, a dispersive ground pad canfunction as current return and voltage references.

The electrosurgical device 14 is configured to deliver the RF energy viaa virtual electrode arrangement, which includes distribution of a fluidalong the exterior surface of each cushion 42 and, upon activation ofthe electrode array 44, the fluid may carry, or otherwise promote,energy emitted from the electrode array 44 to the surrounding tissue. Inparticular, each cushion 42 includes one or more perforations 48 influid communication with at least one lumen of the probe shaftconfigured receive a fluid, such as saline, from a fluid source (e.g.,the irrigation drip 22). The one or more perforations 48 allow thepassage of the fluid to the exterior surface of the cushion 42. Asshown, each of the perforations 48 are generally aligned with anassociated conductive wire 46. Accordingly, upon fluid weeping throughthe perforations 48, a pool or thin film of fluid is formed on theexterior surface of the cushion 42 and configured to ablate and/orcoagulate via the electrical current conducted by the one or moreconductive wires 46 of the electrode array 44, as described in greaterdetail herein.

FIGS. 5A and 5B are front views of the opposing jaws 38 a, 38 b of theend effector assembly 16 in open and closed positions, respectively. Insome embodiments, both jaws 38 a, 38 b may move relative to one anotherand the probe shaft. In other embodiments, one of the jaws 38 may befixed in position relative to the probe shaft while the other jaw 38 isconfigured to move relative to both the fixed jaw and the probe shaft.The opposing jaws 38 a, 38 b are configured to transition between openand closed positions in response to user input with the tirgger 40, asshown in FIGS. 5A and 5B. For example, in the default open position,both jaws are spaced a distance D₁ apart when the trigger 40 is notcompressed. The distance D₁ between the jaws 38 a, 38 b may generally besufficient to receive a stapled portion of tissue or vessel therebetween. Once the target portion of tissue or vessel is positionedbetween the opposing jaws 38 a, 38 b when in the open position, thesurgeon need only compress the trigger 40, which, in turn, results inmovement of the jaws 38 a, 38 b towards one another and the targetportion of tissue or vessel and be held or grasped in betweent the jaws38 a, 38 b as the distance there between decreases until at least adistance D₂ is reached, in which the target portion of tissue or vesselis compressed betweent the jaws 38 a, 38 b. Upon transitioning the jaws38 a, 38 b to the closed position, sealing, cauterizing, coagulating,and/or desiccating of the target portion of tissue or vessel can occur,as will be described in greater detail herein.

FIG. 6 is an enlarged view of another embodiment of an end effectorassembly 16 a compatible with an electrosurgical device 14 consistentwith the present disclosure. Unlike the end effector assembly 16 ofFIGS. 2, 3, 4, and 5A-5B, the end effector assembly 16 a is configuredto laparoscopic procedures, in that the opposing jaws 38 a, 38 b includeatraumatic tips and have a much more narrow profile. FIG. 7 is a planview of one of the opposing jaws 38 a of the end effector assembly 16 aillustrating the deformable cushion and electrode array providedthereon.

FIG. 8 illustrates positioning of the end effector assembly 16 forsealing of a stapled portion of lung tissue (lobe) in an open surgicalenvironment.

FIG. 9 illustrates positioning of the end effector assembly 16 a forsealing of a stapled bronchial passageway via laparoscopic procedure. Asshown, the end effector assembly 16 a is configured to laparoscopicprocedures, in that the opposing jaws 38 a, 38 b include atraumatic tipsand have a much more narrow profile when compared to the configurationof the end effector assembly 16.

FIGS. 10A and 10B are side views of the end effector assembly 16 in openand closed positions, respectively, relative to a portion of stapledlung tissue (of FIG. 8), illustrating the cushions 42 a, 42 b of thecorresponding opposing jaws 38 a, 38 b transitioning from a defaultshape (FIG. 10A) to a deformed shaped (FIG. 10B) and conforming to thetissue surface and in compliance with the staple.

As shown, once a surgeon positions the end effector assembly 16 relativeto a target tissue to be sealed, the surgeon may then close the jaws 38a, 38 b so as to clamp the target tissue there between. Upontransitioning the opposing jaws 38 a, 38 b to the closed position, thecorresponding cushions 42 a, 42 b engage opposing sides of the targettissue, including one or more sutures or staples. The surgeon can applyforce so as to compress the target tissue between the opposing cushions38 a, 38 b, wherein the exterior surface of each cushion 42 a, 42 bgenerally conforms to the surface of the tissue and the staple whilemaintaining the integrity of the staple (i.e., without damaging thestaple). Due to the conforming nature of the cushions 38 a, 38 b, eachelectrode array 44, specifically the conductive wires 46 is able to comeinto close contact with, and effectively seal, portions of the targettissue that are immediately adjacent to the staple, which are generallymissed with current electrosurgical forceps. As shown, the end effectorassembly 16 can generally accommodate an entire cross section of thelung tissue (lobe) to be received between the opposing jaws 38 a, 38 b.

The surgeon may then activate both the fluid delivery and eletrode array44, each of which can be independently controlled via controller 18, aspreviously described. The fluid weeping through the perforations 48, tothe outer surface of the cushions 42 a, 42 b is able to carry energyfrom electrode array 44, thereby creating a virtual electrode. Upon thefluid weeping through the perforations 48, a pool or thin film of fluidis formed on the exterior surface of the cushions 38 a, 38 b and isconfigured to seal portions of the target tissue in contact therewithvia the RF energy carried from the electrode array 44. Accordingly, theelectrosurgical device 14 of the present disclosure provides forcomplete closure of the target tissue, thereby preventing or reducingthe risk of leakage of air, contents, or fluid and subsequentlypreventing infection or life threatening complications that mayotherwise occur with simply a suture or staple closure.

The electrosurgical device of the present disclosure provides numerousadvantages. In particular, the electrosurgical device is useful forsupplementing an initial closure of a vessel, wound, or incision viasuturing or stapling. The deformable cushion on each opposing jaw isconfigured to deform upon being compressed against the target tissue orvessel and the suture(s) or staple(s) such that the exterior surface ofeach cushion conforms and corresponds to the tissue or vessel surfaceand suture(s) or staple(s). The cushion is able to be compressed againstthe suture or staple without causing phyiscal damage thereto orcomprimising the structural integrity of the suture or staple.Furthermore, due to the conforming nature of the cushions, eachelectrode array is able to come into contact with, and effectively seal,portions of the target tissue or vessel that are immediately adjacent tothe suture(s) or staple(s), which are generally missed with currentelectrosurgical forceps as a result of the rigid, non-compliant sealingplates of such forceps. The virtual electrode arrangement of the presentdevice further allows for a non-sticking surface during a sealingprocedure, as the saline generally acts as a buffer between the tissuesurface and the surface of the conductive wires. Furthermore, thevirtual electrode provides for controlled emission of energy, includingat least length of elapsed time and intensity, which, in turn,effectively controls the thermal energy released for sealing, which canbe consistently maintained between 60° C. and 100° C. to preventinadvertent damage to surrounding tissue.

Reference throughout this specification to “one embodiment” or “anembodiment” means that a particular feature, structure, orcharacteristic described in connection with the embodiment is includedin at least one embodiment. Thus, appearances of the phrases “in oneembodiment” or “in an embodiment” in various places throughout thisspecification are not necessarily all referring to the same embodiment.Furthermore, the particular features, structures, or characteristics maybe combined in any suitable manner in one or more embodiments.

The terms and expressions which have been employed herein are used asterms of description and not of limitation, and there is no intention,in the use of such terms and expressions, of excluding any equivalentsof the features shown and described (or portions thereof), and it isrecognized that various modifications are possible within the scope ofthe claims. Accordingly, the claims are intended to cover all suchequivalents.

Incorporation by Reference

References and citations to other documents, such as patents, patentapplications, patent publications, journals, books, papers, webcontents, have been made throughout this disclosure. All such documentsare hereby incorporated herein by reference in their entirety for allpurposes.

Equivalents

Various modifications and further embodiments are possible beyond whatis shown and described herein. The subject matter herein containsinformation, exemplification, and guidance that can be adapted to createvarious other embodiments.

What is claimed is:
 1. A device for sealing tissue or vessels, thedevice comprising: a handle including a proximal end and a distal endand at least one lumen extending therethrough; and an end effectorassembly extending from the distal end of the handle, the end effectorassembly comprises opposing jaws, at least one of which moves relativeto the other, wherein each jaw comprises: a deformable cushion includinga plurality of perforations in communication with the at least one lumenof the handle, the deformable cushion is configured to transition from adefault state to a deformed state upon application of a compressionforce thereto and return to the default state upon removal of thecompression force therefrom, wherein the plurality of perforations areconfigured to allow the passage of a fluid from the lumen of the handleto an exterior surface of the deformable cushion; and an electrode arraycomprising a plurality of conductive wires positioned on the exteriorsurface of the deformable cushion and configured to conduct energy forablation or coagulation of a stapled portion of a target tissue orvessel.
 2. The device of claim 1, wherein the handle comprises a triggerconfigured to control movement of one or both jaws relative to oneanother between the open and closed positions.
 3. The device of claim 1,wherein, in the closed position, the opposing jaws compress the stapledportion of target tissue or vessel there between.
 4. The device of claim3, wherein the exterior surface of the cushion of each jaw is configuredto compress inwardly and conform to the surface of the staple and thesurface of the target tissue or vessel, to thereby enable sealing of thetarget tissue or vessel without compromising the structural integrity ofthe staple or the target tissue or vessel.
 5. The device of claim 4,wherein portions of the electrode array are maintained a close distanceto portions of the target tissue or vessel on both sides of, andimmediately adjacent to, the staple.
 6. The device of claim 1, whereinthe cushion of each jaw comprises a nonconductive material.
 7. Thedevice of claim 1, wherein the cushion of each jaw comprises a shapememory material.
 8. The device of claim 1, wherein the cushion of eachjaw comprises an elastomeric material.
 9. The device of claim 1, whereinthe fluid is a conductive fluid.
 10. The device of claim 1, wherein anexterior surface of the cushion of each jaw comprises at least oneportion of surface texturing to enhance fluid distribution.
 11. Thedevice of claim 1, wherein delivery of fluid to the end effectorassembly and through the plurality of perforations on the cushion ofeach jaw is controllable via a controller.
 12. The device of claim 1,wherein each opposing jaw comprises an atraumatic distal tip.
 13. Thedevice of claim 1, wherein an exterior surface of the cushion of eachjaw is configured to couple energy from the electrode array with thefluid to provide a non-stick surface when the energy is applied to thetarget tissue or vessel.
 14. The device of claim 1, wherein at least oneof the plurality of conductive wires is configured to conduct energy tobe carried by fluid passing through the plurality of perforations to theexterior surface of the deformable cushion to thereby provide a virtualelectrode arrangement.
 15. The device of claim 14, wherein the energy isradiofrequency (RF) energy.
 16. The device of claim 14, wherein thefluid is conductive fluid.
 17. The device of claim 16, wherein theconductive fluid is saline.
 18. The device of claim 1, wherein each ofthe plurality of conductive wires is aligned with a separate respectiveone of the plurality of perforations.
 19. The device of claim 1, whereineach of the plurality of conductive wires, or one or more sets of acombination of conductive wires, is configured to independently receivean electrical current from an energy source and independently conductenergy.
 20. The device of claim 19, wherein the plurality of conductivewires are equidistantly spaced apart from one another along a length ofthe exterior surface of the deformable cushion.